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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Involvement Module
Family Involvement
in Transitions to
Adulthood
May 24, 2011
Webinar presented by Johanna Bergan, Sandy
Bumpus, Pauline Jivanjee, Marlene Penn, Sandra
Spencer, and Gwen White.
2
RESEARCH
RESEARCH&
& TRAINING
TRAININGCENTER
CENTER FOR
ON PATHWAYS
PATHWAYS TO
TO POSITIVE
POSITIVE FUTURES
FUTURES
Introduction:
Johanna Bergan
Marlene Penn
Youth M.O.V.E. National
Iowa
Family member, Family Technical
Assistance Consultant
New Jersey
Sandy Bumpus
Sandra Spencer
Family member
Oregon
Family member, National
Federation of Families for
Children’s Mental Health
Maryland
Pauline Jivanjee
Gwen White
Pathways RTC, Portland State
University
Oregon
Healthy Transitions Initiative
Washington, DC
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Involvement Objectives
• Articulate the value to young people of having family
members involved in services
• Navigate the legal and policy contexts of families
involved in the transition year
• Call upon Family Support Organizations and Parent
Advocates to support families in transition
• Involve families engaged in services in productive
ways
• Engage with diverse families
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
The Family Journey
• The voyage metaphor
• The natural pulling apart of adult
family members and youth as
youth become more
independent
• Forced disconnection within the
treatment system between
young adults and families
• System can be very disrespectful
to youth and families
Presenter: Sandra Spencer, Maryland
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Relationships with Providers
• Families are a resource
and generally want to be
helpful
• Youth in crisis may not see
what families have to offer
•
•
•
•
Social and emotional
supports
Financial help (housing, bills, access to health care)
Treatment
Education
Presenter: Sandra Spencer, Maryland
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Relationships with Providers
•
Providers should be prepared
to speak about the value of
involving families
•
The “deskilling” process (Harden,
2005)
•
Parents initially felt confident,
but having service providers
undermine their expertise and good judgment by
questioning and marginalizing what they had attempted to
do with their children led to feelings of inadequacy.
Presenter: Sandra Spencer, Maryland
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Families
• Professional language can
create a gap
• Families need to be talked
with clearly and without
jargon
• Providers must be willing to
answer questions and
provide access to information
Presenter: Marlene Penn, New Jersey
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Families
• Support families in the balancing
act between families wanting to
protect their child and needing to
let them make mistakes
• Don’t condemn families if their
child makes mistakes
• Get families involved in Family
Support Organizations and link
them with Family/Parent
Advocates
Presenter: Marlene Penn, New Jersey
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Relationships with Parent Advocates
• Help other parents navigate the system and access
traditional and non-traditional services
• Translate the content and process of meetings with
service provider (Munson et al, 2009)
• Work to empower parents and youth so that their voices
are heard in service systems
• Serve as networking agents to link parents with others
with similar experiences
• Bring their valuable personal experiences to bear, and
give hope (Hoagwood, 2005; Munson et al, 2009, Robbins et al, 2008)
Presenter: Marlene Penn, New Jersey
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Youth Perspectives
• Some young people may be
grateful for support that family
members offer them as they work
toward recovery and independence
(Preyde, Cameron, Frensch, & Adams, 2011)
• Other young people may want to
strike out on their own and not
want other family members in their
business (Arnett, 2000)
• Youth may not have the option to choose between
adulthood and childhood when navigating systems
Presenter: Johanna Bergan, Iowa
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Preparation for Transitions
Mental health issues for family discussion:
• Is the young person able to discuss her/his condition with
significant people?
• Can the young adult articulate her/his MH and other needs?
Does s/he know how to access health/MH information?
• Does the young person know how to access community
resources and agencies?
• Does the young person understand when to discuss her/his
condition?
• Can the young person advocate for her/himself? (Holmbeck et al, 2010)
Presenter: Johanna Bergan, Iowa
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Young People
• Listen, treat young people with
respect and dignity
• Offer information to young people
and a voice in decisions
• Create opportunities to use
experiences for growth, increased
skills, self-esteem
• Encourage supportive relationships
with family, friends, and others
Presenter: Johanna Bergan, Iowa
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Young People
• Support involvement in groups such
as youth activities, clubs, faith
communities
• Promote autonomy, personal
agency, empowerment, social
inclusion (Osgood, Foster & Courtney, 2010)
• Create opportunities to give and
receive peer support
• Involve families (Federation of Families for
Children’s Mental Health, 2001)
Presenter: Johanna Bergan, Iowa
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Legal and Policy Issues
• Becoming an adult doesn’t
happen on a birthday
• Individual and Family
developmental changes
happen gradually
• Institutional Transitions are
mediated by bureaucratic and
legal rather than cultural or
natural guidelines
Presenter: Gwen White, Washington ,DC
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Legal Issues: 4 C’s and a G
Consent
• Shift of legal responsibility
• Age of consent varies by state
Confidentiality
• According to HIPAA – Health Insurance
Portability & Accountability Act of 1996
(PL 104-191) providers cannot discuss
health information with a parent unless
the youth specifically grants permission
Competency
• When a young adult is clearly not competent to make independent
health care decisions, a parent may petition the court to become
their child’s guardian.
Presenter: Gwen White, Washington, DC
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Legal Issues: 4 C’s and a G
Guardianship
• A guardian is appointed to arrange care of a person
• Generally done prior to the age of 18
• Requires an attorney, filling for a petition and having a court
visitor interview the young adult
• The protected person must be in agreement
• No universally accepted definition of competence
Conservator
• A conservator is appointed to make decisions about property
and assets
Terms and conditions vary state-to-state.
Presenter: Gwen White, Washington, DC
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Policy and Practice Issues
Policy
• About systems changing not young adults and families
adapting
• Policies based on functioning rather than a birth date
• Health Care changes
Practice
•
•
•
•
Recognize the importance of Adult Allies
Work with youth and family competent organizations
The workforce is different
Create Communication Pathways
Presenter: Gwen White, Washington, DC
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Diverse Families
• Young people live in many different
family structures
• As a service provider, do I know
who the young people I work with
define as family and what are their
preferences for family involvement
in services?
• How can I find information and advice about the racial and ethnic
diversity of families I am encountering and how can I develop
skills in providing culturally responsive services?
• Am I tuned in to the over-representation of youth of color in more
restrictive settings and the challenges facing families who want to
participate in their children’s treatment?
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Working with Diverse Families
• Service providers working with African American young
people recommend long-term resilience-oriented
strategies that include activities where youth can
experience success
• For example, Self-Enhancement, Inc. in Portland, OR
provides after-school and school enrichment programs,
and relationships with mentors planned with family
involvement
• Protective factors include strong kinship ties (Joe, 2006)
• Involvement of community supports such as churches can
be valuable, although not all families want this (Lindsey et al.,
2006)
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Interventions with Diverse Families
• Do I seek to connect Native
American youth and families to
culturally-specific agencies that
use holistic approaches rooted in
traditional teachings?
• Interventions at programs such as
NAYA Family Center in Portland
incorporate cultural
activities and the development of positive cultural identity
• Families are encouraged to draw from traditional culture and
spiritual teachings to guide their relationships with young
people (Cross et al., 2007)
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Immigrant Families
• As of 2010, 24% of youth in the U.S. are from
immigrant families, with higher rates of anxiety,
depression, PTSD, and suicidality
• For effective work with immigrant families, am I
thinking about protective factors such as respect,
loyalty to family, and the development of
biculturalism?
• Do I focus my interventions on promoting a strong
sense of positive cultural identity to reduce the
depressive effects of discrimination?
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Working with Immigrant Families
• Helping relationships for Latino
adolescents are oriented to
health promotion involving
family, friends, peer supports,
and other community supports
that young people trust (Garcia &
Saewyc, 2007)
• In my work with Latino families, do I seek ways to facilitate
youth-family communication to build understanding and
appreciation of strengths? (Chapman & Pereira, 2005)
• Do I reach out to community resources and engage in
advocacy on behalf of vulnerable families?
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Youth who Identify as LGBTQQIA2-S
• Families with a youth who identify as
LGBTQIQ2-S may experience varying levels of
acceptance and support when using mental
health services
• Do I use asset-based approaches to promote
LGBTQIQ2-S resiliency through building
positive identity, reducing stigma, and
promoting strong relationships with peers,
supportive families, positive role models,
and adult allies? (Gamache & Lazear, 2009)
• Example of the Sexual & Gender Minority Youth Resource Center
(SMYRC) in Portland: Drop in center and developmentally
appropriate programming
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Practice Guidelines
• Am I aware of families’ different cultural beliefs about
mental health and have I clarified their expectations of
treatment outcomes?
• Do I respond with humility and reflection and seek clarity
where I don’t understand?
• Do I know where to seek culturally relevant and specific
services and supports?
• Am I working to support the development of positive
ethnic and cultural identity as a protective factor?
• Have I sought mentors to bring knowledge of youth
culture to adult family members?
Presenter: Pauline Jivanjee, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Support Organizations (FSO)
• A national network of FSOs advocates for
the rights of children and youth with
mental health challenges and their
families, and provides training and
technical assistance (Gyamfi et al, 2010)
• FSOs provide whatever it takes for families to achieve the balance
they need, including support groups and parent advocates in the
context of systems of care (Koroloff & Friesen, 1991; Kutash & Rivera, 1996)
• FSOs certify Parent Advocates
• Allies in advocating for change
• Help providers evaluate acceptability services
Presenter: Sandy Bumpus, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Support Organizations
• National Federation of Families for Children’s Mental
Health
http://www.ffcmh.org/
• National Alliance for the Mentally Ill (NAMI)
http://www.nami.org/
• Parents, Families and Friends of Lesbians and Gays
(PFLAG) has over 500 chapters nationwide and provides
community-based support and advocacy for families
http://community.pflag.org/
Presenter: Sandy Bumpus, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Programs
• La Familia Counseling Services and Family Support Services
www.lafamiliacounselingservice.com
•
An organization in Sacramento, CA focused on community empowerment and
leadership development through mental health wellness in the Latino community.
La Familia promotes a focus on the family at all levels of service delivery, and
believes that the healing process can more effectively take place in the context of
the family.
• Self-Enhancement, Inc. http://www.selfenhancement.org
•
A Portland, OR nonprofit organization helping at-risk African-American urban
youth. SEI provides family resource services such as counseling, parenting classes,
energy assistance and housing programs, and other useful training.
• FosterClub http://www.fosterclub.com/
•
FosterClub is the national advocacy network for young people in foster care. Their
website includes a section for “grownups,” which includes information and
training for foster families and a supportive message board for adults.
Presenter: Sandy Bumpus, Oregon
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Programs
• Native American Youth and Family Center http://www.nayapdx.org/
•
NAYA provides educational services, cultural arts programming, and direct support
to reduce poverty to the Portland metropolitan area's American Indian and Alaska
Native community. NAYA Family Center provides family services to strengthen
family and community ties. Family services include Healing Circle, Foster Care
Support Program, Positive Indian Parenting, and Elders services.
• Sexual & Gender Minority Youth Resource Center
http://www.smyrc.org
•
SMYRC provides a safe, supervised, harassment-free, and alcohol- and drug-free
space for sexual minority youth 23 and younger. SMYRC also provides free family
counseling services to sexual minority youth and their families. SMYRC provides
the only drop-in resource center for sexual minority youth in Oregon. Youth
gather to participate in positive activities like art, music, community organizing,
youth development, education, peer support, support groups, case management,
counseling, and job readiness preparation.
Presenter: Sandy Bumpus, Oregon
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RESEARCH
RESEARCH&
& TRAINING
TRAININGCENTER
CENTER FOR
ON PATHWAYS
PATHWAYS TO
TO POSITIVE
POSITIVE FUTURES
FUTURES
Question and Answer Session
Q&A
Presenter: Pauline Jivanjee, Oregon
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RESEARCH
RESEARCH&
& TRAINING
TRAININGCENTER
CENTER FOR
ON PATHWAYS
PATHWAYS TO
TO POSITIVE
POSITIVE FUTURES
FUTURES
Additional Questions
If you have additional questions
or feedback, please contact us
Eileen Brennan, Co-Principal Investigator: [email protected]
Pauline Jivanjee, Co-Principal Investigator: [email protected]
Eliz Roser, Graduate Research Assistant:
[email protected]
Our project website
www.pathwaysrtc.pdx.edu/proj-trainingcollaborative.shtml
Presenter: Pauline Jivanjee, Oregon
31
Acknowledgments/Funders
The development of the contents of this presentation were supported by funding from the National
Institute of Disability and Rehabilitation Research, United States Department of Education, and the
Center for Mental Health Services Substance Abuse and Mental Health Services Administration,
United States Department of Health and Human Services (NIDRR grant H133B090019). The content
does not represent the views or policies of the funding agencies. In addition, you should not
assume endorsement by the Federal Government.